Provider Demographics
NPI:1912122474
Name:PRECISION ORTHOPEDICS
Entity Type:Organization
Organization Name:PRECISION ORTHOPEDICS
Other - Org Name:ORTHOPEDIC SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:E
Authorized Official - Last Name:COOK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-265-7175
Mailing Address - Street 1:PO BOX 660046
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75266-0046
Mailing Address - Country:US
Mailing Address - Phone:972-791-1224
Mailing Address - Fax:972-819-0500
Practice Address - Street 1:8440 WALNUT HILL LN
Practice Address - Street 2:STE 110
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-3833
Practice Address - Country:US
Practice Address - Phone:214-265-7175
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PRECISION ORTHOPEDICS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-04-17
Last Update Date:2011-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Multi-Specialty
No207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic SurgeryGroup - Multi-Specialty
No207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Multi-Specialty
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Multi-Specialty
No207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic TraumaGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0053BYOtherBCBS
TXCE9700Medicare PIN
TX0053BYOtherBCBS